Skills-knowledge-attitude-training-experience (SKATE) in ‘designing for occupational health of construction workers’

This research was funded by B&CE (a non-profit organisation offering products and benefits to working people in the construction sector). The research was supported by the Design for Health Task Group (DfHTG) of the Health in Construction Leadership Group (HCLG). While construction workers’ health has long been neglected at the expense of safety, it is now an important focus of the industry. Aligned to this, there is a growing recognition that design decisions have a major influence on the occurrence of health hazards in construction (e.g. noise, dust) that can lead to work-related or work-exacerbated conditions such as hearing loss and respiratory illnesses. The Health and Safety Executive (HSE) requires that those designing “should eliminate foreseeable health and safety risks to anyone affected by the work (if possible) and take steps to reduce or control risks that cannot be eliminated” (HSE 2019). The Construction (Design and Management) Regulations (CDM 2015), an important mechanism for addressing health (and safety) hazards in design, requires individuals working on projects to have relevant skills, knowledge and experience to enable them to design for health. Additionally, clients recognise the importance of designers’ abilities in understanding how and why to incorporate more healthy products and processes into projects. However, to date the industry continues to struggle with the make-up of these attributes, that are essential for designers to be able to design safe and healthy projects. This is particularly the case in respect of ‘Design for Health’ given the long neglect of health issues in construction. This project, designed to be a collaboration between key experts in the industry, allowed for further discussion on the key attributes required of designers to enable them to Design for Health in the construction industry (reviewing skills, knowledge, attitude, training, experience - SKATE). Workshops were the main data collection method. However, in order to engage a broader participant sample, these were supplemented by interviews and questionnaires. Although all workshops and interviews commenced with a brief introduction to the concept of ‘Designing for Health’ of construction workers, many participants appeared to fail to grasp the concept specifically, as they had a tendency during discussions to keep highlighting safety examples. Comments made by respondents strongly suggest that many design teams are still struggling to apply the principles of the CDM Regulations to construction safety challenges, let alone occupational health challenges of construction workers. This may be due to the focus of information and training being more towards safety rather than health. Most designers were aware of the risks of falls from height and asbestos, but were less likely to be aware of other risks such as dust or noise. The findings suggest that company size and project size were relevant with regards to an individual’s levels of competence in the SKATE qualities and ease of access to other individuals with the required SKATE within teams. However, project type did not appear relevant to SKATE: there was no clear view that a particular type of project required particular SKATE. While different projects may require different solutions, the key is that designers have general health awareness to identify where and how their design decisions can make a difference. While participants highlighted positive suggestions that could help achieve better Design for Health in the future, many also raised various limitations. Responses from a number of participants highlighted the concern about the ‘unregulated’, smaller residential, Do-it-yourself (DIY) self-build market. Participants also discussed concerns about challenges of Designing for Health due to competing priorities, cost constraints, design time pressures, fragmentation of the role, lack of ownership, lack of health awareness, lack of site experience and limited available guidance. It would appear that the term ‘Design for Health’ could be misleading, as there was a tendency to focus only on the end user and not the construction worker. Taking into account the findings of this research, the research team suggest that greater use of the term ‘Prevention through Design’ (which is commonly used in the United States of America (USA)), rather than the terms usually used in the United Kingdom (UK), ‘Designing for Safety’, ‘Designing for Health’ may increase the chance that occupational health is taken as seriously as safety. First, this report describes limiting factors in designing for occupational safety and health (i.e. mainly ‘safety’ and the requirements of CDM) and secondly, focuses on opportunities for designing specifically for the occupational health of construction workers.